War and humanitarianism, medicine and public health, rights and justice... Discover CRASH publications sorted by themes.
The fact that CRASH publications are written from an aid practitioner's, rather than researcher's, perspective, does not exempt them from the demands of rigorous research methods. We try hard at this, with the help of (volunteer) research professionals. The publications are not the MSF party line, but rather tools for reflexion based on MSF's framework and experience. They have only one purpose: to help us better understand what we are doing. Criticisms, comments and suggestions are more than welcome - they are expected.
Access to health products: which priorities and what role for MSF ?
On 3rd and 4th February 2022, the CRASH organised a workshop aimed principally at the directors and operational managers of MSF Operational Centre Paris (OCP) to reflect on current debates, and to determine which elements of the discussion would be the most relevant to resolve to support the advancement of MSF OCP’s operational projects. Is Access to Medicines the same issue today as it was when MSF first became interested in the mid-1990s? Rather than just concentrating on the obstacles to accessing medicines, should the debate be broadened to encompass what are now called ‘health products’ or even further, towards access to care and thus largely structural problems of human resources, financing, or the absence of national health insurance policies?
'Forgive us for inconveniencing you by not letting them drown'
This op-ed by Isabelle Defourny and Michaël Neuman was published in the newspaper Le Monde on November 23rd, 2022.
Controlling an HIV Hotspot. A Realistic Ambition?
This article was published on December 22nd, 2021, in the Journal of Humanitarian Affairs (Issue 3, Volume 3).
Despite a concerted international effort in recent decades that has yielded significant progress in the fight against HIV/AIDS, the disease continues to kill large numbers of people, especially in certain regions like rural Ndhiwa district in Homa Bay County, Kenya. Although there is still no definitive cure or vaccine, UNAIDS has set an ambitious goal of ending the epidemic by 2030, specifically via its 90-90-90 (treatment cascade) strategy – namely that 90 per cent of those with HIV will know their status; 90 per cent of those who know their status will be on antiretroviral therapy and 90 per cent of those on antiretroviral therapy will have an undetectable viral load. These bold assumptions were put to the test in a five-year pilot project launched in June 2014 by Médecins Sans Frontières (MSF) and Kenya’s Ministry of Health in Ndhiwa district, where an initial NHIPS 1 study by Epicentre (MSF’s epidemiology centre) in 2012 revealed some of the world’s highest HIV incidence and prevalence, and a poor “treatment cascade”. Six years later a new Epicentre study, NHIPS 2, showed that the 90-90-90 target had been more than met. What explains this ‘success’? And given the still-high incidence, is it truly a success? What follows is an interview on the political, scientific, and operational challenges of the Ndhiwa project with MSF Deputy Director of Operations Pierre Mendiharat and physician Léon Salumu, Head of MSF France Kenya programs, conducted by Elba Rahmouni.
MSF and Ebola in Nord Kivu. Positioning, Politics and Pertinence
This article was published on December 22nd, 2021 in the Journal of Humanitarian Affairs (Issue 3, Volume 3).
In this article, Natalie Roberts analyses the actions and positioning of MSF during the Ebola outbreak in Nord Kivu (Democratic Republic of Congo, 2018-2020).
What AIDS teaches us
In this article, Rony Brauman identifies the dynamics and events that made bending the HIV/AIDS epidemic curve possible. He explains the climate in which the tug-of-war with parts of the pharmaceutical industry played out from MSF’s perspective, and recalls that fears about international security and political stability also helped push governments to mobilise against the epidemic.
Management of the suffering child: a medical and operational challenge
Based on the example of the hospital in Moïssala, Chad, the two authors reflect on the management of pain in children at Médecins Sans Frontières. This article was first published on March 25th 2022 in the journal Alternatives Humanitaires.
Reconstructing Lives: Victims of war in the Middle East and Médecins Sans Frontières
Reconstructing Lives: Victims of war in the Middle East and Médecins Sans Frontières was published in January 2022 by Manchester University Press. The book is the result of extensive fieldwork, in collaboration with the Crash. It is fully available on our website.
About the possibility of controlling an HIV epidemic hotspot
This article was first released in the 18th volume of the Humanitarian Alternatives magazine. Designed to reduce the incidence of HIV/AIDS in a Kenyan district, a Médecins Sans Frontières project successfully exceeded the “90-90-90” target set by UNAIDS. A look back on the results that the authors of this article - Pierre Mendiharat, Deputy director of operations at MSF France and Léon Salumu Luzinga, Program manager at MSF France, interviewed by Elba Rahmouni - believe are encouraging but by no means a guarantee that the epidemic will be over by 2030.
Patrick de Saint-Exupéry: a counterfaiter in Congo
In his book, La Traversée. Une odyssée au cœur de l’Afrique, Patrick de Saint-Exupéry challenges the reality of Hutu Rwandan refugees’ hunt and massacre facing the advancement of the Rwandan Patriotic Army and their Congolese allies in 1996-97. This systematic exercise of denying reality – especially the denial of the Mapping Report written by the Office of the United Nations High Commissioner for Human Rights (1143 pages, published in June 2009) – but also this denial of Human Rights Advocacy groups’ investigations, and those of journalists’ witnesses present in DRC at the time – does not spare MSF’s teams who came to help these refugees in 1996-97. However, as a front-line witness of the Tutsi genocide in Rwanda, MSF was also one of the organizations noticing the intense violence perpetrated by the new Rwandan political regime in Zaire / DRC back in 1996 and 1997, mostly against a population constituted at three-quarters of women and children.